Thyroid cancer

Medicine2

Thyroid cancer is a malignant thyroid tumor. There are several forms of this type of cancer. The most common is papillary cancer, which, unlike other forms, is less aggressive, so the results of its treatment are quite successful. Forms of thyroid cancer that emanate from differentiated cells (true cancer or carcinoma) grow slowly and later metastasize. Undifferentiated thyroid cancer develops rapidly. However, this form of cancer is relatively rare. Even so rarely is the so-called medullary form of cancer (cancer of the C-cells). The development of the disease is associated with a genetic predisposition.

Symptoms

Early symptoms:

  • A modification of the previously enlarged thyroid gland.
  • Appearance of nodes.
  • Sensation of neck tightness.

Late symptoms:

  • Dense, with uneven surface, nodes.
  • Hoarseness.
  • Increased cervical lymph nodes.
  • Dyspnea.
  • Decreased body weight.

The first symptoms of the disease - the appearance of a node on the neck, an increase in the cervical lymph nodes. Most often, the tumor begins to form from a node formed on the goiter. After the radiological examination of the gland on the scintigram is seen the so-called. A "cold" node. "Cold" nodes are tissues that appeared as a result of bleeding, cysts, calcification, inflammation, scarring of the thyroid gland due to iodine deficiency. Many of these sites are benign.

Causes

The reasons for the development of the thyroid tumor are not entirely clear. It is proved that the onset of cancer is affected by ionizing radiation, hormonal imbalance, and predisposition to certain forms of cancer is due to heredity.

It has already been proven that one of the main causes of cancer in the thyroid gland is ionizing radiation. At one time in the USA, x-ray irradiation was actively used to treat lymphadenitis, enlarged tonsils, adenoids, etc. And in 1978, American physicians found that one in five of the patients, who were treated like this in childhood, showed cancer. Among Japanese exposed to the explosion of atomic bombs in Hiroshima and Nagasaki, thyroid cancer was observed 10 times more often than among the rest of the population of Japan. In the Bryansk, Tula, Ryazan and Oryol regions of Russia, according to data obtained in 1993, after the Chernobyl accident, the incidence of thyroid cancer in children aged 5-9 years increased by 4.6-15.7 times compared with The national average. I must say that the incidence of thyroid cancer by regions of Russia is not uniform. Thus, the greatest number of cases of cancer in men is recorded in the Orel, Bryansk, Ivanovo regions, and in women - in Arkhangelsk, Sverdlovsk and Bryansk.

Researchers have established that thyroid cancers often occur against a background of hypothyroidism. The reason for this is an increased content of thyroid-stimulating hormone (TSH) in the blood, which has a stimulating effect on the thyroid gland. There is information that the most aggressive forms of cancer are most often found in countries with severe iodine deficiency.

It should also be noted that more than half of the patients with papillary and follicular cancer had a combination of several predisposing factors.

Thus, the group at increased risk for this pathology includes:

  • Women, long-term suffering from inflammatory or neoplastic diseases of the genitals and mammary glands;
  • People with hereditary predisposition to tumors and dysfunction of endocrine glands;
  • Patients suffering from adenoma of the thyroid gland;
  • People exposed to general or local effects on the head and neck of ionizing radiation, especially in childhood.

The emergence of thyroid cancer in all countries has two peaks: a smaller one - in the age range from 7 to 20 years, a larger one - in 40-65 years. Especially often, cancer occurs in patients aged 43-44 years.

How to treat?

If in countries with developed medicine, for example, Israel or Germany, the question of the best ways to treat thyroid cancer raises fierce disputes among endocrinologists, in our country there is much less disagreement on this score: patients are recommended for surgical intervention. And most surgeons prefer to remove not only the tumor, but also surrounding tissues, not without reason believing that they can also contain unrecognized cancer cells. In addition, during the operation, a significant part of the cervical lymph nodes is often removed, as the most likely site of metastasis formation. This is particularly true for surgery for medullary carcinoma.

Here, probably, it is appropriate to note that among patients there is a stable opinion that the operative treatment of thyroid diseases is better spent in the cold season. There is no scientific justification for this statement. When appointing an operation to remove the tumor, the surgeon is guided by the fact that the tumor should be removed as soon as possible, and also by how long it may take for preoperative preparation - for example, removal of the symptoms of thyrotoxicosis with the help of medications. So, if a tumor removal surgery is offered in the summer, there is no point in delaying it until winter.

Sometimes after the operation, patients are prescribed treatment with radioactive iodine - as in diffuse toxic goiter. With medullary carcinoma, this method is not used, since parafollicular cells do not accumulate radioactive iodine. In an attempt to combat recurrences of the disease, doctors sometimes prescribe patients with medullary carcinoma with external radiation therapy and chemotherapy, but the results of the studies show that this usually does not increase the patient's life-span. It is also inappropriate to use external radiation in the treatment of papillary and follicular carcinoma.

After the detection of differential carcinoma and the beginning of treatment, there is almost always a probability that the tumor will continue its growth. With this pathology, surgery is indicated. During surgery, the entire thyroid gland is usually removed. If the cancer metastasized into nearby tissues and lymph nodes, they also have to be removed. If after the operation in the human body there are remains of thyroid tissue that produces hormones, then in a few weeks the patient is prescribed irradiation with radioactive iodine. Then every day the patient should take hormone pills. These hormones are full replacements of thyroid hormones, which the human body is no longer able to produce.

Treat yourself a tumor of the thyroid gland can not. If someone in the family has had various thyroid disorders, regular checkups should be carried out regularly.

At an early stage, the symptoms are almost not observed. Often, a cancerous tumor is detected only during an operation conducted for some other reason. Any knot, palpable on the neck, should examine the doctor.

It is not always possible to diagnose the tumor immediately. The doctor, suspecting a malignant tumor, examines the patient with a scanner, makes a puncture biopsy, examines a piece of tissue through a microscope. If the diagnosis is confirmed, the patient is hospitalized in an oncological hospital.

Thyroid cancer, like any other malignant tumor, is dangerous. Especially it affects middle-aged women (after 40 years).

For the prevention of thyroid disease, it is recommended to use iodine, for example, salt enriched with iodine.

 

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